What is Torticollis?

Torticollis literally means twisted neck. It is a something you have most likely had at one time or another—many of us have probably woken up with it after sleeping in an unusual position.  However it can also occur in newborns.

In newborns, it is called infant torticollis or congenital muscular torticollis and it is relatively common. Boys and girls develop it equally.  The cause is not exactly clear. It may occur if the baby’s head is in the wrong position while growing in the womb, or if the muscles or blood supply to the neck are damaged. It may also occur after a difficult birth, especially if the baby is very large or is delivered in a breech position.

In torticollis, the sternocleidomastoid muscle, the large, rope-like muscle that runs on both sides of the neck from the back of the ears to the collarbone, is stretched or pulled. If it tears, then it causes bleeding and bruising within the muscle. Scar tissue then develops and this causes the muscle to shorten and tighten, pulling the baby’s head to one side. The scar tissue forms a mass or lump that sometimes can be felt on the side of the neck.

Congenital muscular torticollis may be visible at birth or it may not become evident until several weeks later. The following are the most common symptoms:
• tilting of the baby’s head to one side
• the baby’s chin turns toward the opposite side
• a firm, small, one to two centimeter mass is present in the middle of the sternocleidomastoid muscle

Babies may experience symptoms differently. And the symptoms of torticollis may resemble other neck masses or medical problems, so it is always important to talk to your baby’s health care provider if you are concerned.
In most cases torticollis is diagnosed through a physical exam, but sometimes x-rays and ultrasound may also be utilized.

Treating torticollis involves stretching the neck muscle. Passive stretching and positioning are used in infants and small children. The best way to treat torticollis is to encourage your baby to turn his or her head in both directions. This will help to loosen tense neck muscles and tighten the loose ones. Also it is important to remember tummy time.  Tummy time  helps to build both neck and shoulder muscles and helps your baby get ready to crawl.  Tummy time is important for all babies—not just those with torticollis.

Most babies with torticollis improve with stretching and positioning exercises.  In some cases though, surgery to correct the neck muscle may be necessary. Again, if you think your baby may have torticollis, make sure to talk to your health care provider.

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